Most patients with STIs prefer to inform their partners by telephone or face to face, a study from Australia has found.

Patients diagnosed with a bacterial STI at the Sydney Sexual Health Centre, over a three-month period in 2010, were studied. Data were extracted on: age, gender, bacterial STI diagnosed, number of sexual partners identified at the treatment visit, number of partners the index case was able to notify, methods used for partner notification and the known outcomes of notification.

There were 224 patients diagnosed with one or more of gonorrhoea, chlamydia and infectious syphilis.

Of these, 52 patients either declined or could not be contacted by the clinic. There were no significant differences in age, gender (of index case or partners) between those able and unable to be contacted for follow-up.

Of the 172 patients (77%) who were contacted by the clinic, six could not contact any partners, one chose provider referral, two opted for a combination of both provider and patient referral and 163 chose patient referral. The 172 index cases nominated a total of 1,010 sexual partners of whom 494 (49%) were contacted by the index case and 447 (91%) were successfully informed of the infection, giving a median of two partners per case (range 0-25).

The index cases also reported that 175 (39%) of partners notified had sought testing and treatment, but there were uncertainties about the remaining 272 (61%). Three of the index cases referred 26 partners for provider referral. This was undertaken either by telephone or email. The most common method of partner notification by index case was by phone (37%) and face to face (22%).

Those who were more likely to use face-to-face partner notification were: • Younger (< 30 years), adjusted odds ratio (OR) 2.8 (95% CI:1.4-5.7; P = 0.001)

• Patients who reported fewer than two sexual partners OR 3.6 (95% CI:1.7-7.6; P = 0.001) or

• Patients who spoke a language other than English OR 3.1 (95% CI:1.3-7.2; P = 0.005).

Patients diagnosed with syphilis were significantly less likely to use an interactive contact tracing method i.e. face to face or telephone OR 0.24 (95% CI:0.09-0.67; P = 0.09).

Reporting fewer than two partners was the single predictor for using interactive contact methods; OR 2.7 (95% CI:1.3-5.5; P = 0.001).

Patients diagnosed with bacterial STIs informed most of their traceable partners by telephone or face to face; non face-to-face methods were used by men who have sex with men and those diagnosed with syphilis.

There appeared to be a reducing likelihood of notification in person the more partners there were to notify. Conversely, those with fewer sexual partners were more likely to notify them by interactive methods. Current partners were more likely to have been reported as contacted and treated than past or casual partners.

Partner notification is usually seen as a barrier to managing bacterial STIs in primary care. Although this study took place in Australia, the findings demonstrate the willingness of the majority of index cases to use patient referral for partner notification, either by telephone or face to face.

The authors comment that effective contact tracing probably requires a range of options to help patients contact partners. With increasing means of electronic communication, this should no longer be a barrier for GPs and nurses to manage STIs in primary care.

Dr Richard Ma

• Knight V, Ryder N, Bourne C, McNulty A. A cross sectional study of how people diagnosed with a bacterial sexually transmitted infection inform their partners. Sex Transm Infect 2014;90:588–591. doi:10.1136/sextrans-2013-051482